高级搜索

细胞减灭术加腹腔热灌注化疗治疗胃癌腹膜癌的系统分析

姬忠贺, 梁寒, 季加孚, 于洋, 李鑫宝, 李雁

姬忠贺, 梁寒, 季加孚, 于洋, 李鑫宝, 李雁. 细胞减灭术加腹腔热灌注化疗治疗胃癌腹膜癌的系统分析[J]. 肿瘤防治研究, 2017, 44(12): 796-803. DOI: 10.3971/j.issn.1000-8578.2017.17.0563
引用本文: 姬忠贺, 梁寒, 季加孚, 于洋, 李鑫宝, 李雁. 细胞减灭术加腹腔热灌注化疗治疗胃癌腹膜癌的系统分析[J]. 肿瘤防治研究, 2017, 44(12): 796-803. DOI: 10.3971/j.issn.1000-8578.2017.17.0563
JI Zhonghe, LIANG Han, JI Jiafu, YU Yang, LI Xinbao, LI Yan. Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy on Gastric Cancer Peritoneal Carcinomatosis: A Systemic Analysis[J]. Cancer Research on Prevention and Treatment, 2017, 44(12): 796-803. DOI: 10.3971/j.issn.1000-8578.2017.17.0563
Citation: JI Zhonghe, LIANG Han, JI Jiafu, YU Yang, LI Xinbao, LI Yan. Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy on Gastric Cancer Peritoneal Carcinomatosis: A Systemic Analysis[J]. Cancer Research on Prevention and Treatment, 2017, 44(12): 796-803. DOI: 10.3971/j.issn.1000-8578.2017.17.0563

细胞减灭术加腹腔热灌注化疗治疗胃癌腹膜癌的系统分析

基金项目: 

首都临床特色应用研究与成果推广项目 Z161100000516077

北京市自然科学基金 7172108

首都医科大学附属北京世纪坛医院重点学科建设项目 2016fmzlwk

详细信息
    作者简介:

    姬忠贺(1991-),男,博士在读,主要从事腹膜癌的临床研究

    通讯作者:

    李雁, E-mail: liyansd2@163.com

  • 中图分类号: R735.2

Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy on Gastric Cancer Peritoneal Carcinomatosis: A Systemic Analysis

More Information
  • 摘要:
    目的 

    系统分析肿瘤细胞减灭术(cytoreductive surgery, CRS)加腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy, HIPEC)治疗胃癌腹膜癌(gastric cancer peritoneal carcinomatosis, GC PC)的应用现状及发展方向。

    方法 

    检索CRS+HIPEC治疗GC PC相关临床研究文献,提取生存及安全性相关数据,进行系统分析。

    结果 

    GC PC的自然病程不超过5月,CRS+HIPEC可延长GC PC患者总生存期(overall survival, OS)。在前瞻性临床研究中CRS+HIPEC组中位OS为11.0月,在回顾性临床研究中CRS+HIPEC组中位OS为13.3月。CRS+HIPEC治疗GC PC围手术期死亡率低于6.5%,严重不良事件发生率无显著上升。

    结论 

    CRS+HIPEC治疗GC PC疗效显著,有望成为部分经选择的GC PC患者的首选治疗。

     

    Abstract:
    Objective 

    To evaluate the clinical trials of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) on gastric cancer peritoneal carcinomatosis (GC PC).

    Methods 

    The published clinical trials of CRS+HIPEC on GC PC were critically evaluated, with survival and safety as the primary endpoints.

    Results 

    The natural course of GC PC was < 5 months. CRS+HIPEC could improve the overall survival (OS). In prospective studies, the median OS was 11.0 months in the CRS+HIPEC group. In retrospective studies, the median OS was 13.3 months in the CRS+HIPEC group. The perioperative mortality was less than 6.5%, and there was no statistically significant increase in serious adverse events directly attributable to CRS+HIPEC.

    Conclusion 

    CRS+HIPEC is a promising integrated treatment strategy for GC PC to produce improved treatment efficacy, and should be recommended as the first treatment choice for selected patients with GC PC.

     

  • 胃癌(gastric cancer, GC)占癌症相关死亡的9%,中国GC新发病例数占世界GC新发病例的40%[1-2]。约30%的GC患者初诊时已发生区域播散而形成腹膜癌(peritoneal carcinomatosis, PC),表现为大小、数量不等的肿瘤结节弥漫分布于腹膜和肠系膜表面,导致难治性腹水、进行性肠梗阻和顽固性腹痛[3]。传统的GC PC治疗手段主要包括系统化疗、姑息手术和支持治疗等,疗效甚微,患者中位生存期(overall survival, OS)不足6月,生活质量极差[4]

    过去的30年里,随着对PC病理机制的认识和治疗技术的进步,诊断和治疗取得了显著进展。肿瘤学界认识到,部分PC属区域性癌转移,而非广泛转移的终末期表现,肿瘤细胞减灭术(cytoreductive surgery, CRS)加腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy, HIPEC)的综合治疗策略,通过CRS切除肉眼可见的病灶,HIPEC清除微转移癌和游离癌细胞,可有效控制PC进展,部分患者还可能达到临床治愈[5]

    本研究旨在系统分析现有的循证医学证据,探讨研究GC PC的临床意义、自然病程、CRS+HIPEC治疗GC PC的安全性和有效性,展望GC PC治疗策略的发展方向。

    检索数据库包括Medline、PubMed、Web of Science、Cochrane library;检索时间范围为1980年1月至2017年1月;检索关键词包括“gastric cancer”、“hyperthermic intraperitoneal chemotherapy”、“HIPEC”及自动匹配的Mesh主题词;综述文章用于逆向查找相关临床研究论文;同一临床研究增加样本量或延长随访结果等,仅纳入最近一次研究结果。

    所有检索结果均由两位研究者独立评价,并经两轮筛选,见图 1。第一轮筛选阅读标题、摘要、关键词,排除综述、基础研究、病例报道及不相关的临床研究论文。关于CRS+HIPEC治疗GC PC的临床研究进入第二轮筛选。第二轮筛选阅读全文,将病例数大于10例、含OS结果、并发症和死亡率信息的文献纳入本研究。对有分歧而难以确定的研究,由第三位研究者参与评价,共同商讨决定。

    图  1  文献筛选流程及结果
    Figure  1  Flow chart of search process and results
    GC: gastric cancer; PC: peritoneal carcinomatosis; CRS: cytoreductive surgery; HIPEC: hyperthermic intraperitoneal chemotherapy

    两位研究者独立提取数据,包括发表时间、研究类型(随机对照研究、前瞻性研究、回顾性病例对照研究、回顾性队列研究)、国别、病例数、治疗方法、HIPEC参数、生存结果(中位/平均OS、1、2、3、5年生存率及其他生存数据)、并发症发生率、死亡率、多因素分析结果等。

    数据采用简单计数、均值、中位值进行描述性统计。数据处理、表格制作采用Excel 2010软件(Microsoft Corp., Redmond, USA)和SPSS Statistics 20(International Business Machines Corp., New York, USA)软件进行,流程图绘制采用Power point 2010软件(Microsoft Corp., Redmond, USA)进行。

    涉及不同时间段和不同地域人群的多项国际性大样本临床研究显示,PC是最常见、侵袭性最强的GC转移类型,是目前GC治疗中面临的最大挑战。

    意大利的前瞻性临床研究中[6],441例GC患者接受标准根治术后,中位随访48月,215例(48.8%)出现肿瘤复发转移,其中77例(35.8%)PC、57例(26.5%)肝转移、49例(22.8%)淋巴结转移、34例(15.8%)胃床或邻近脏器转移、13例(6.0%)残胃癌及20例(9.3%)其他部位(肺、骨、皮肤、脑)转移;从相关危险度来看,Lauren组织学分型为弥漫型的危险度为4.3,浆膜受累为3.36,淋巴结转移为2.67,肿瘤大小为1.11;Lauren分型为弥漫型且浆膜受累的GC患者,5年PC风险高达69%。

    一项中美联合临床研究纳入了1 058例(美国414例,中国644例)T1~2N0期的胃腺癌患者,均经R0胃切除术,5年复发率达7%(76/1 058),中国患者复发率8%(51/644)、美国复发率6%(25/414)。肝转移占43%、PC占16%、淋巴结转移占10%、吻合口复发占8%。该研究证明,即使是早期GC患者接受根治性手术,腹膜仍是主要复发部位[7]

    在GC早期的腹腔镜手术时代,PC仍然是GC治疗失败的首要原因。一项纳入1 874例GC患者的回顾性研究中,816例接受开放手术,1 058例接受腹腔镜手术,均为R0切除加D1或D2淋巴结清扫术。中位随访43.3月,腹腔镜手术组复发49例,其中23例(46.9%)为PC;开放手术组复发179例,其中113例(63.1%)为PC。该研究提示,浆膜未受侵的GC患者接受腹腔镜胃切除术后,PC仍为最严重的复发形式[8]

    一项单中心研究[9]和一项人群研究[4]揭示了GC PC的自然病程,为临床研究提供了基线数据。2000年,法国单中心研究[9]首次系统描述了125例GC PC患者的自然病程,即平均OS 6.5月,中位OS 3.1月。2014年的荷兰人群大样本研究[4],5 220例GC患者中,13.5%(706/5 220)发生PC,PC占所有转移形式的34.8%(706/2 029)。GC PC的高危因素包括女性、肿瘤浸润达浆膜、淋巴结阳性、腺癌伴印戒细胞或革囊胃、原发瘤涉及胃的多个解剖部位。PC为唯一转移部位的GC患者,中位OS为4.6月;PC并其他转移的GC患者中位OS为3.3月。GC PC患者切除原发瘤可有效延长OS(9.9月 vs. 3.7月)。因此,GC PC的自然病程一般不超过5月。

    在全球范围内广泛开展的回顾性研究、队列研究、前瞻性研究,初步证实了CRS+HIPEC治疗GC PC的临床疗效及安全性。本综述共纳入了29项临床研究[10-38],见图 1。总计1 863例GC PC患者,其中1 659例来源于回顾性研究,204例来源于前瞻性研究,见表 1

    表  1  CRS+HIPEC治疗GC PC临床研究基本信息
    Table  1  Major characteristics of CRS+HIPEC studies for GC PC
    下载: 导出CSV 
    | 显示表格

    CRS+HIPEC可显著延长部分GC PC患者OS。29项研究中[10-38]提取的生存数据显示不同研究类型之间,中位OS无明显差异,见表 2

    表  2  CRS+HIPEC治疗GC PC生存相关结果
    Table  2  Survival outcomes of CRS+HIPEC on GC PC patients
    下载: 导出CSV 
    | 显示表格

    在5项前瞻性临床研究中,CRS+HIPEC组中位OS为11.0(10.0~11.3)月,单纯CRS组为5.4(4.3~6.5)月。在8项回顾性病例对照研究中,CRS+HIPEC组中位OS为13.3(8.0~24.5)月,单纯CRS组为7.9(5.0~11.0)月。在16项回顾性队列研究中,CRS+HIPEC治疗GC PC患者的中位OS为13.3(6.6~37.0)月,1年中位生存率为50.0%(41.2%~83.4%),2年中位生存率35.8%(19.9%~69%),5年中位生存率为13.0%(6.4%~31.0%)。

    16项研究中进行了多因素分析,鉴定出了部分独立预后因子。从被鉴定出的频率来看,细胞减灭程度(completeness of cytoreduction, CCR)共11次,腹膜癌指数(peritoneal cancer index, PCI)共4次,HIPEC、系统化疗和TNM分期各3次,腹水、组织分型、体力状态、腹膜切除和术后并发症各2次。

    CRS+HIPEC治疗GC PC的安全性已被验证,主要不良事件包括肠梗阻、脓毒血症、切口感染、低蛋白血症、吻合口瘘、胸腔积液等,围手术期死亡率低于6.5%,见表 3

    表  3  CRS+HIPEC相关并发症发生率、死亡率及严重不良事件
    Table  3  Mortality, morbidity and serious adverse events (SAEs) of CRS+HIPEC
    下载: 导出CSV 
    | 显示表格

    在对GC PC的认识和诊疗过程中,我们取得了哪些成功?还遗留哪些难题?从本文中,我们至少了解到以下几点事实。

    第一,GC PC越来越被重视。法国的单中心研究[9]和荷兰的人群研究[4]获得了GC PC的基线数据,均表明GC PC的自然病程很短,中位OS不超过5月,传统治疗模式不能延长GC PC患者生存期,临床亟需突破。CRS+HIPEC治疗GC PC相关论文发表逐渐增多,涉及地区更加广泛,证据质量越来越高,这充分表明GC PC越来越受重视,相关研究日益活跃。

    第二,PC是GC最常见的转移形式,急需鉴定高危因素。目前唯一的大样本人群研究[4]发现,超过三分之一的GC转移表现为PC。GC PC危险因素包括女性、肿瘤浸润深度达浆膜、淋巴结阳性、腺癌伴印戒细胞或革囊胃、原发瘤涉及多个胃的解剖部位及Lauren组织学分型为弥漫型。胃癌转移理论需要观念上的更新,根治性手术后,GC转移遵循逐步发展的模式,PC是最早发生、也是最关键的转移部位,其他形式的转移紧随其后。因此,GC可能并非早期全身转移,而是早期以PC为主要形式的腹腔内播散,随后远处转移率逐渐增加[39]。不论是基础研究还是临床试验均应更加重视GC PC。

    第三,需要深化认识GC PC的肿瘤生物学规律,更新治疗理念。涉及不同历史时期和地理区域的人群临床研究均提示GC PC是最大难题,现有的GC标准根治术,在治疗理念、方案设计及技术实施上均可能存在缺陷。这种治疗形式主要通过扩大切除范围控制局部原发肿瘤、系统化疗控制血道和淋巴道转移,但对于区域种植转移关注不足。这正是PC成为GC最常见复发转移形式的主因。GC治疗现状亟需改善,治疗理念和策略设计方面需要更新。

    第四,CRS+HIPEC综合治疗策略整合了手术切除、化疗、热疗及物理灌洗效应,可为GC PC患者带来临床获益[40]。近三十年来,CRS+HIPEC治疗GC PC,在全球肿瘤学界广泛研究,有足够证据支持CRS+HIPEC的疗效,规范化CRS+HIPEC可延长GC PC患者中位OS至13月,较传统治疗方法OS延长近一倍。CRS+HIPEC安全性可接受,围手术期死亡率低于6%,3~4级不良事件发生率低于20%,与常规普外科大手术相比无显著差异。医学界经历了30多年才认识并接受手术切除对结直肠癌肝转移的疗效[19],依此推算,接受CRS+HIPEC作为GC PC有效治疗策略的时机已日趋成熟。

    第五,为确保疗效减少不良事件,务必谨慎筛选病例。常规体检、体力状态评估、营养状态评估、主要器官功能评估、肿瘤标志物检查及专科影像学检查等,均属必要[6]。PCI和CCR最早由Sugarbaker描述[41-42],是关键的预后因子,已作为纳入标准写入各个国家或机构的专家共识中[5, 19]。评估可切除性的最准确方式还是剖腹探查或腹腔镜探查[22]

    第六,HIPEC技术仍需规范。目前没有证据显示开放性HIPEC和闭合性HIPEC的疗效差异,两种技术临床上都可接受。从药物选择来看,丝裂霉素加顺铂为主的方案、以铂类为主的方案和以多西他赛为主的方案均可行[43]。细胞毒药物的选择主要考虑其浸润深度和细胞毒效应,并不要求严格与病理类型相关[43]。丝裂霉素加顺铂为主的药物方案,在40℃~43℃下行开放性HIPEC 60~90 min,流速控制在500 ml/min,是目前最常用的HIPEC方案。

    第七,在CRS+HIPEC治疗GC PC临床试验仍有诸多缺陷,主要问题是缺乏多中心临床研究和国际性合作研究得出的高级别循证医学证据。目前许多国家已经建立了专业的腹膜癌中心,积累了足够的手术经验,开展国际合作的多中心RCTs,制订CRS+HIPEC治疗GC PC的国际指南条件已经成熟。此外,标准化的操作规范对该技术的传播应用亦非常重要。

    因此,CRS+HIPEC是疗效明确、前景广阔的综合治疗策略,给GC PC患者带来显著生存获益,有望成为部分经选择的GC PC患者的首选治疗。

  • 图  1   文献筛选流程及结果

    Figure  1   Flow chart of search process and results

    表  1   CRS+HIPEC治疗GC PC临床研究基本信息

    Table  1   Major characteristics of CRS+HIPEC studies for GC PC

    下载: 导出CSV

    表  2   CRS+HIPEC治疗GC PC生存相关结果

    Table  2   Survival outcomes of CRS+HIPEC on GC PC patients

    下载: 导出CSV

    表  3   CRS+HIPEC相关并发症发生率、死亡率及严重不良事件

    Table  3   Mortality, morbidity and serious adverse events (SAEs) of CRS+HIPEC

    下载: 导出CSV
  • [1]

    Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012 [J]. CA Cancer J Clin, 2015, 65(2): 87-108. doi: 10.3322/caac.21262

    [2]

    Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015 [J]. CA Cancer J Clin, 2016, 66(2): 115-32. doi: 10.3322/caac.21338

    [3]

    Yonemura Y, Canbay E, Li Y, et al. A comprehensive treatment for peritoneal metastases from gastric cancer with curative intent [J]. Eur J Surg Oncol, 2016, 42(8): 1123-31. doi: 10.1016/j.ejso.2016.03.016

    [4]

    Thomassen I, van Gestel YR, van Ramshorst B, et al. Peritoneal carcinomatosis of gastric origin: A population-based study on incidence, survival and risk factors [J]. Int J Cancer, 2014, 134(3): 622-8. doi: 10.1002/ijc.28373

    [5]

    Li Y, Zhou YF, Liang H, et al. Chinese expert consensus on cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal malignancies[J]. World J Gastroenterol, 2016, 22(30): 6906-16. doi: 10.3748/wjg.v22.i30.6906

    [6]

    Roviello F, Marrelli D, de Manzoni G, et al. Prospective study of peritoneal recurrence after curative surgery for gastric cancer[J]. Br J Surg, 2003, 90(9): 1113-9. doi: 10.1002/(ISSN)1365-2168

    [7]

    Cao L, Selby LV, Hu X, et al. Risk factors for recurrence in T1-2N0 gastric cancer in the United States and China[J]. J Surg Oncol, 2016, 113(7): 745-9. doi: 10.1002/jso.v113.7

    [8]

    Lee JH, Lee CM, Son SY, et al. Laparoscopic versus open gastrectomy for gastric cancer: long-term oncologic results[J]. Surgery, 2014, 155(1): 154-64. doi: 10.1016/j.surg.2013.06.015

    [9]

    Sadeghi B, Arvieux C, Glehen O, et al. Peritoneal carcinomatosis from non-gynecologic malignancies: results of the EVOCAPE 1 multicentric prospective study[J]. Cancer, 2000, 88(2): 358-63. doi: 10.1002/(ISSN)1097-0142

    [10]

    Yang XJ, Huang CQ, Suo T, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer: final results of a phase Ⅲ randomized clinical trial[J]. Ann Surg Oncol, 2011, 18(6): 1575-81. doi: 10.1245/s10434-011-1631-5

    [11]

    Glehen O, Gilly FN, Arvieux C, et al. Peritoneal carcinomatosis from gastric cancer: a multi-institutional study of 159 patients treated by cytoreductive surgery combined with perioperative intraperitoneal chemotherapy[J]. Ann Surg Oncol, 2010, 17(9): 2370-7. doi: 10.1245/s10434-010-1039-7

    [12]

    Rudloff U, Langan RC, Mullinax JE, et al. Impact of maximal cytoreductive surgery plus regional heated intraperitoneal chemotherapy (HIPEC) on outcome of patients with peritoneal carcinomatosis of gastric origin: results of the GYMSSA trial[J]. J Surg Oncol, 2014, 110(3): 275-84. doi: 10.1002/jso.23633

    [13]

    Yang XJ, Li Y, Yonemura Y. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy to treat gastric cancer with ascites and/or peritoneal carcinomatosis: Results from a Chinese center[J]. J Surg Oncol, 2010, 101(6): 457-64. doi: 10.1002/jso.v101:6

    [14]

    Glehen O, Schreiber V, Cotte E, et al. Cytoreductive surgery and intraperitoneal chemohyperthermia for peritoneal carcinomatosis arising from gastric cancer[J]. Arch Surg, 2004, 139(1): 20-6. doi: 10.1001/archsurg.139.1.20

    [15]

    Beaujard AC, Glehen O, Caillot JL, et al. Intraperitoneal chemohyperthermia with mitomycin C for digestive tract cancer patients with peritoneal carcinomatosis[J]. Cancer, 2000, 88(11): 2512-9. doi: 10.1002/(ISSN)1097-0142

    [16]

    Wu HT, Peng KW, Ji ZH, et al. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy with lobaplatin and docetaxel to treat synchronous peritoneal carcinomatosis from gastric cancer: Results from a Chinese center[J]. Eur J Surg Oncol, 2016, 42(7): 1024-34. doi: 10.1016/j.ejso.2016.04.053

    [17]

    Tu Y, Tian Y, Fang Z, et al. Cytoreductive surgery combined with hyperthermic intraperitoneal chemoperfusion for the treatment of gastric cancer: A single-centre retrospective study[J]. Int J Hyperthermia, 2016, 32(6): 587-94. doi: 10.1080/02656736.2016.1190987

    [18]

    Boerner T, Graichen A, Jeiter T, et al. CRS-HIPEC prolongs survival but is not curative for patients with peritoneal carcinomatosis of gastric cancer[J]. Ann Surg Oncol, 2016, 23(12): 3972-77. doi: 10.1245/s10434-016-5306-0

    [19]

    Passot G, Vaudoyer D, Villeneuve L, et al. What made hyperthermic intraperitoneal chemotherapy an effective curative treatment for peritoneal surface malignancy: A 25-year experience with 1, 125 procedures[J]. J Surg Oncol, 2016, 113(7): 796-803. doi: 10.1002/jso.v113.7

    [20]

    Desantis M, Bernard JL, Casanova V, et al. Morbidity, mortality, and oncological outcomes of 401 consecutive cytoreductive procedures with hyperthermic intraperitoneal chemotherapy (HIPEC)[J]. Langenbecks Arch Surg, 2015, 400(1): 37-48. doi: 10.1007/s00423-014-1253-z

    [21]

    Yarema RR, Ohorchak MA, Zubarev GP, et al. Hyperthermic intraperitoneal chemoperfusion in combined treatment of locally advanced and disseminated gastric cancer: results of a single-centre retrospective study[J]. Int J Hyperthermia, 2014, 30(3): 159-65. doi: 10.3109/02656736.2014.893451

    [22]

    Magge D, Zenati M, Mavanur A, et al. Aggressive locoregional surgical therapy for gastric peritoneal carcinomatosis[J]. Ann Surg Oncol, 2014, 21(5): 1448-55. doi: 10.1245/s10434-013-3327-5

    [23]

    Müller H, Hotopp T, Tofeili A, et al. Systemic chemotherapy using FLOT-regimen combined with cytoreductive surgery plus HIPEC for treatment of peritoneal metastasized gastric cancer[J]. Hepatogastroenterology, 2014, 61(131): 703-6. http://europepmc.org/abstract/MED/26176060

    [24]

    Konigsrainer I, Horvath P, Struller F, et al. Initial clinical experience with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in signet-ring cell gastric cancer with peritoneal metastases[J]. J Gastric Cancer, 2014, 14(2): 117-22. doi: 10.5230/jgc.2014.14.2.117

    [25]

    Canbay E, Mizumoto A, Ichinose M, et al. Outcome data of patients with peritoneal carcinomatosis from gastric origin treated by a strategy of bidirectional chemotherapy prior to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in a single specialized center in Japan[J]. Ann Surg Oncol, 2014, 21(4): 1147-52. doi: 10.1245/s10434-013-3443-2

    [26]

    Schildberg CW, Weidinger T, Hohenberger W, et al. Metastatic adenocarcinomas of the stomach or esophagogastric junction (UICC stage Ⅳ) are not always a palliative situation: a retrospective analysis[J]. World J Surg, 2014, 38(2): 419-25. doi: 10.1007/s00268-013-2293-1

    [27]

    Kang LY, Mok KT, Liu SI, et al. Intraoperative hyperthermic intraperitoneal chemotherapy as adjuvant chemotherapy for advanced gastric cancer patients with serosal invasion[J]. J Chin Med Assoc, 2013, 76(8): 425-31. doi: 10.1016/j.jcma.2013.04.004

    [28]

    Hultman B, Lind P, Glimelius B, et al. Phase Ⅱ study of patients with peritoneal carcinomatosis from gastric cancer treated with preoperative systemic chemotherapy followed by peritonectomy and intraperitoneal chemotherapy[J]. Acta Oncol, 2013, 52(4): 824-30. doi: 10.3109/0284186X.2012.702925

    [29]

    Shen P, Stewart JH 4th, Levine EA. Cytoreductive surgery and intraperitoneal hyperthermic chemotherapy for peritoneal surface malignancy: non-colorectal indications[J]. Curr Probl Cancer, 2009, 33(3): 168-93. doi: 10.1016/j.currproblcancer.2009.06.005

    [30]

    Scaringi S, Kianmanesh R, Sabate JM, et al. Advanced gastric cancer with or without peritoneal carcinomatosis treated with hyperthermic intraperitoneal chemotherapy: a single western center experience[J]. Eur J Surg Oncol, 2008, 34(11): 1246-52. doi: 10.1016/j.ejso.2007.12.003

    [31]

    Zhu ZG, Tang R, Yan M, et al. Efficacy and safety of intraoperative peritoneal hyperthermic chemotherapy for advanced gastric cancer patients with serosal invasion. A long-term follow-up study[J]. Dig Surg, 2006, 23(1-2): 93-102. doi: 10.1159/000093778

    [32]

    Yonemura Y, Kawamura T, Bandou E, et al. Treatment of peritoneal dissemination from gastric cancer by peritonectomy and chemohyperthermic peritoneal perfusion[J]. Br J Surg, 2005, 92(3): 370-5. doi: 10.1002/(ISSN)1365-2168

    [33]

    Hall JJ, Loggie BW, Shen P, et al. Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for advanced gastric cancer[J]. J Gastrointest Surg, 2004, 8(4): 454-63. doi: 10.1016/j.gassur.2003.12.014

    [34]

    Fujimura T, Yonemura Y, Nakagawara H, et al. Subtotal peritonectomy with chemohyperthermic peritoneal perfusion for peritonitis carcinomatosa in gastrointestinal cancer[J]. Oncol Rep, 2000, 7(4): 809-14. http://www.oalib.com/references/7734737

    [35]

    Hirose K, Katayama K, Iida A, et al. Efficacy of continuous hyperthermic peritoneal perfusion for the prophylaxis and treatment of peritoneal metastasis of advanced gastric cancer: evaluation by multivariate regression analysis[J]. Oncology, 1999, 57(2): 106-14. doi: 10.1159/000012016

    [36]

    Yonemura Y, Fujimura T, Nishimura G, et al. Effects of intraoperative chemohyperthermia in patients with gastric cancer with peritoneal dissemination [J]. Surgery, 1996, 119(4): 437-44. doi: 10.1016/S0039-6060(96)80145-0

    [37]

    Yonemura Y, Fujimura T, Fushida S, et al. Hyperthermo-chemotherapy combined with cytoreductive surgery for the treatment of gastric cancer with peritoneal dissemination[J]. World J Surg, 1991, 15(4): 530-5. doi: 10.1007/BF01675656

    [38]

    Fujimoto S, Takahashi M, Mutou T, et al. Improved mortality rate of gastric carcinoma patients with peritoneal carcinomatosis treated with intraperitoneal hyperthermic chemoperfusion combined with surgery[J]. Cancer, 1997, 79(5): 884-91. doi: 10.1002/(ISSN)1097-0142

    [39]

    Averbach AM, Jacquet P. Strategies to decrease the incidence of intra-abdominal recurrence in resectable gastric cancer[J]. Br J Surg, 1996, 83(6): 726-33. doi: 10.1002/(ISSN)1365-2168

    [40]

    Sugarbaker PH. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of gastrointestinal cancers with peritoneal metastases: Progress toward a new standard of care[J]. Cancer Treat Rev, 2016, 48: 42-9. doi: 10.1016/j.ctrv.2016.06.007

    [41]

    Sugarbaker PH. Successful management of microscopic residual disease in large bowel cancer[J]. Cancer Chemother Pharmacol, 1999, 43(Suppl):S15-25. doi: 10.1007/s002800051093

    [42]

    Sugarbaker PH. Cytoreductive surgery and peri-operative intraperitoneal chemotherapy as a curative approach to pseudomyxoma peritonei syndrome[J]. Eur J Surg Oncol, 2001, 27(3): 239-43. doi: 10.1053/ejso.2000.1038

    [43]

    Lemoine L, Sugarbaker P, Van der Speeten K. Drugs, doses, and durations of intraperitoneal chemotherapy: standardising HIPEC and EPIC for colorectal, appendiceal, gastric, ovarian peritoneal surface malignancies and peritoneal mesothelioma[J]. Int J Hyperthermia, 2017, 33(5): 582-92. doi: 10.1080/02656736.2017.1291999

图(1)  /  表(3)
计量
  • 文章访问数:  1327
  • HTML全文浏览量:  320
  • PDF下载量:  411
  • 被引次数: 0
出版历程
  • 收稿日期:  2017-05-21
  • 修回日期:  2017-07-12
  • 网络出版日期:  2024-01-12
  • 刊出日期:  2017-12-24

目录

/

返回文章
返回
x 关闭 永久关闭